2021
DOI: 10.3389/fonc.2020.613669
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Abstract: Proton therapy has advantages and pitfalls comparing with photon therapy in radiation therapy. Among the limitations of protons in clinical practice we can selectively mention: uncertainties in range, lateral penumbra, deposition of higher LET outside the target, entrance dose, dose in the beam path, dose constraints in critical organs close to the target volume, organ movements and cost. In this review, we combine proposals under study to mitigate those pitfalls by using individually or in combination: (a) bi… Show more

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Cited by 20 publications
(26 citation statements)
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“…Seated positioning is typical for ocular treatments and for some specific disease sites; it was also historically the method used at pioneering facilities yet with less success than supine treatments ( 108 ). Now, with the advent of modern delivery techniques, superior dose distributions can be achieved with seated treatments and clinical advantages with better immobilisation have also been reported ( 109 ). The use of vertical CT enables imaging of patients with the same treatment position for treatment planning and positioning errors can also be corrected with geometrical adjustments of the chair (i.e.…”
Section: Limitations and Avenues For Improvementsmentioning
confidence: 99%
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“…Seated positioning is typical for ocular treatments and for some specific disease sites; it was also historically the method used at pioneering facilities yet with less success than supine treatments ( 108 ). Now, with the advent of modern delivery techniques, superior dose distributions can be achieved with seated treatments and clinical advantages with better immobilisation have also been reported ( 109 ). The use of vertical CT enables imaging of patients with the same treatment position for treatment planning and positioning errors can also be corrected with geometrical adjustments of the chair (i.e.…”
Section: Limitations and Avenues For Improvementsmentioning
confidence: 99%
“…Nevertheless, overall patient comfort is an important consideration for upright treatments and Mazal et al. ( 109 ) list several cases where there could be advantages, such as increased ease with patient anesthesia or airway management. Furthermore, the increased availability of physical space with a fixed beamline also enables greater flexibility with the beam optics and delivery components.…”
Section: Limitations and Avenues For Improvementsmentioning
confidence: 99%
See 2 more Smart Citations
“…Practical solutions are small dosimeters, such as alanin pellets, and radiochromic films that can be cut into user-defined shapes and sizes [51][52][53]. Experiments with new radiation qualities, such as FLASH radiotherapy, laser-driven sources or proton mini-beams, demand for adapted solutions with respect to sample positioning and dosimetry [54][55][56][57]. Moreover, point-like measurements with small dosimeters can be supported by simulations [58] to resolve proton dose distributions [59,60].…”
Section: The Physicist's Point Of Viewmentioning
confidence: 99%